高尿酸血症对肩袖腱骨愈合的影响  

Experimental study on the effect of hyperuricemia on rotator cuff tendon-bone healing

作　　者：马金龙 韩增帅 张益 姜弘元[2] 张英泽 于腾波[4] Ma Jinlong;Han Zengshuai;Yi Zhang;Jiang Hongyuan;Zhang Yingze;Yu Tengbo(Department of Rehabilitative Medicine,Qingdao Municipal Hospital,Qingdao 266071,China;Department of Orthopedics,Affiliated Hospital of Qingdao University,Qingdao 266100,China;Department of Orthopedics,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China;Department of Orthopedics,Qingdao Municipal Hospital,Qingdao 266071,China)

机构地区：[1]青岛市市立医院康复医学科,青岛266071 [2]青岛大学附属医院骨科,青岛266100 [3]河北医科大学第三医院骨科,石家庄050051 [4]青岛市市立医院骨科,青岛266071

出　　处：《中华实验外科杂志》2023年第12期2554-2558,共5页Chinese Journal of Experimental Surgery

基　　金：山东省自然科学基金(ZR2019MH097);山东省点研发计划项目(2021SFGC0502)。

摘　　要：目的观察高尿酸血症对大鼠肩袖损伤修复后腱骨愈合的影响。方法将40只SD大鼠按标签数字法随机分为2组,每组20只,正常尿酸组每天给予羧甲基纤维素钠灌胃给药。高血尿酸组每天给予羧甲基纤维素钠配氧嗪酸钾灌胃给药。两组大鼠每周一上午检测血尿酸、肌酐、尿素氮水平并记录。两组大鼠在第4周时损伤冈上肌腱,利用骨隧道缝合方式进行修复。以原来的方式灌胃饲养与定期检测。第8周时,处死大鼠,取肱骨头-冈上肌-肩胛骨标本,进行两组标本大体观察、组织学染色分析、生物力学分析、酶联免疫吸附试验(ELISA)分析,组间比较采用独立样本t检验。结果第8周时,高尿酸组大鼠血尿酸水平高于正常尿酸组[(159.32±5.70)μmol/L比(83.34±8.83)μmol/L,t=22.859,P<0.01];高尿酸组大鼠血肌酐水平高于正常尿酸组[(61.87±4.08)μmol/L比(33.50±3.32)μmol/L,t=17.055,P<0.01];高尿酸组大鼠血尿素氮水平高于正常尿酸组[(9.31±1.12)mmol/L比(5.68±1.05)mmol/L,t=7.455,P<0.01];两组标本肉眼观察结果显示,高尿酸组瘢痕粘连情况较差;组织学染色结果显示,术后4周正常尿酸组可见腱骨愈合层次清晰,胶原纤维排列有序;高尿酸组可见肌腱骨交接面层次不清,胶原纤维排列疏松紊乱;生物力学分析结果显示,高尿酸组最大载荷低于正常尿酸组[(25.54±1.19)N比(35.85±0.45)N,t=-14.073,P<0.01];ELISA炎性因子分析结果显示,高尿酸组标本中炎性因子白细胞介素(IL)-1浓度高于正常组[(34.14±2.58)pg/ml比(8.32±0.69)pg/ml,t=-16.767,P<0.01],IL-6浓度高于正常组[(85.32±4.93)pg/ml比(60.07±7.80)pg/ml,t=-4.737,P<0.01],IL-1b浓度高于正常组[(103.00±1.39)pg/ml比(69.63±0.74)pg/ml,t=-36.738,P<0.01]。结论高尿酸血症不利于大鼠肩袖损伤修复后腱骨愈合。Objective To study the effect of hyperuricemia on tendon bone healing after rotator cuff injury repair in rats.Methods 40 rats from Animal Experimental Center of Qingdao University were randomly divided into two groups according to the label number method.20 rats were given carboxymethyl cellulose sodium by gavage daily,namely normal uric acid group.20 rats were given sodium carboxymethyl cellulose and potassium oxazonate by gavage every day,namely hyperuricemia group.The levels of serum uric acid,serum creatinine and blood urea nitrogen were measured and recorded every Monday morning.At the 4th week,the supraspinatus tendon was injured and the tendon bone was sutured by bone tunnel suture.Feeding by gavage and regular testing were continued as before.At the 8th week,the rats were sacrificed,and the humeral head-supraspinathus-scapula specimens were collected for gross observation,histological staining analysis.The biomechanical results and enzyme-linked immunosorbent assay(ELISA)results of inflammatory factors were analyzed by independent sample t-test.Results The death rate of rats in the high uric acid group was 10%(2/20),and that in the normal uric acid group was 25%(5/20).At the 8th week,the blood uric acid level of rats in the high uric acid group was higher than that in the normal uric acid group[(159.32±5.70)μmol/L vs.(83.34±8.83)μmol/L,t=22.859,P<0.01];Serum creatinine level of rats in high uric acid group was higher than that in normal uric acid group[(61.87±4.08)μmol/L vs.(33.50±3.32)μmol/L,t=17.055,P<0.01].The blood urea nitrogen level of rats in high uric acid group was higher than that in normal uric acid group[(9.31±1.12)mmol/L vs.(5.68±1.05)mmol/L,t=7.455,P<0.01].The results of the two groups showed that the hyperuric acid group had poor scar adhesion.Histological staining results showed that in the normal uric acid group 4 weeks after surgery,the healing level of tendon bone was clear and the collagen fibers were arranged in order.In the high uric acid group,the level of tendon bone jun

关 键 词：高尿酸血症 肩袖损伤 腱骨愈合 

分 类 号：R589.7[医药卫生—内分泌] R68[医药卫生—内科学]